agenda timeline materials activities - … · agenda / timeline materials / activities module 1,...

HHEEAALLTTHHYY LLIIVVIINNGG PPRROOJJEECCTT MODULE 1, SESSION 1 1

Outcome: Client will identify at least one attainable goal related to the Life Project

Skill 1: Client will identify personal strengths related to the Life Project

Skill 2: Client will identify challenges related to the Life Project

OOUUTTCCOOMMEE AANNDD SSKKIILLLLSS

AAGGEENNDDAA / TTIIMMEELLIINNEE MMAATTEERRIIAALLSS / AACCTTIIVVIITTIIEESS

Module 1, Session 1........................90 minutes

•Check-In .........................................20 minutes•Facilitator begins to establish a safe,

supportive rapport with Client•Provide an overview of project content•Discuss Client’s expectations for

participation in this project

•Life Context ...................................50 minutes•Discuss Client’s perceptions of personal

strengths and challenges in the followingareas:

•Physical/medical history•Psychiatric history•Substance use/abuse history•Stigma/discrimination experience(s)

•Client identifies personal strengths andchallenges in the following areas:

•Client’s current living situation•Social and professional relationships•Background and family history•Disclosure issues

•Wrap-Up .........................................20 minutes•Discuss Life Project concept•Review of identified personal strengths•Assist Client in developing his or her

personal Life Project by identifying aclear, realistic, and measurable goalrelated to the Life Project

•Client File•Life Context Form•Goal Card•Goal Recording Sheet•Quality Assurance Check Sheet/Notes•Session Notes

•Pens, pencils

NNOOTTEESS OOUUTTLLIINNEE

•Facilitator begins to establish a safe, supportive rapport withClient

•Explain audiotaping•Discuss payment incentive•Discuss Module length•Discuss length of Healthy Living Project

•Preview the content of all Modules•Module 1

•Stress•Coping•Social Support•Life Project

•Module 2•HIV Knowledge•Safer Behaviors•Assertive Communication/Negotiation•Disclosure Decisions•Keeping Safer

•Module 3•Current Health Behavior•Medical Treatment Adherence•Social Support and Adherence•Maintaining Health•Living Life to Its Fullest

•Discuss Client’s expectations for participation in this study(why did Client agree to participate, what does he/she hope togain from participation, etc.)


check-in 20 MINUTES


•Activity: "Life Context Form" (see pages 5–6 of this session)•Discuss Client’s perceptions of personal strengths and

challenges in the following areas:1. Physical/Medical History

•Including HIV diagnosis (date), AIDS diagnosis(date)

•Medications (HIV-related and non-HIV-related)

2. Psychiatric History•Hospitalizations or treatment•Medications (current and past)•Current diagnosis•Suicidal ideation history

3. Substance Use/Abuse History•Treatment history•Current activity

4. Stigma/Discrimination Experience(s)•Family/friends•Employment•Health care providers

•Client identifies personal strengths and challenges in thefollowing areas:

1. Client’s Current Living Situation•Household members/make-up•Neighborhood•Safety•How long living there?


50 MINUTESlife context


2. Social and Professional Relationships•Significant others (spouse, partner, lovers, others)•Family•Friends (neighborhood, clubs, organizations, etc.)•Co-workers•Health care network•Social service network•Spiritual network•Who is aware of your HIV status?

3. Background and Family History•Family of origin/choice

•Number of family members (living and deceased)•Location of family members•State of relationship(s) (close, distant, estranged,

etc.)•Reliance on members (physical, emotional,

financial, etc.)

4. Education and Professional Experiences

5. Hobbies and Interests


AACCTTIIVVIITTYY: “LLIIFFEE CCOONNTTEEXXTT FFOORRMM”


PHYSICAL/MEDICAL HISTORY

Date of HIV diagnosis Date of AIDS diagnosis (if any)

Medications (HIV-related and non-HIV-related)

PSYCHIATRIC HISTORY

Hospitalizations or treatment

Medications (current and past)

Current diagnosis

Current level of distress

Suicidal ideation history

SUBSTANCE USE/ABUSE HISTORY

Treatment history

Current activity

STIGMA/DISCRIMINATION EXPERIENCE(S)

Family/friends

Employment

Health care providers


CLIENT’S CURRENT LIVING SITUATION

Household members/make-up

Neighborhood

Safety

How long living there?

SOCIAL AND PROFESSIONAL RELATIONSHIPS

Significant others (spouse, partner, lovers, others)

Family

Friends (neighborhood, clubs, organizations, etc.)

Co-workers

Health care network

Social service network

Spiritual network

Who is aware of your HIV status?

Who are the people in your life that are helpful?

BACKGROUND AND FAMILY HISTORY

Family of origin/choice•Number of family members

•Location of family members

•State of relationship(s) (close, distant, estranged, etc.)

•Reliance on members (physical, emotional, financial, etc.)

EDUCATION AND PROFESSIONAL EXPERIENCES

HOBBIES AND INTERESTS


•Discuss Life Project concept•Explore what is important to the Client•Facilitator assists Client in identifying core values, resources

and goals which provide enjoyment, fulfillment, andmeaning

•Discuss Client’s definition of a "life-long goal"•Facilitator assists Client to begin development of a structure

surrounding his/her ideas for the Life Project

•Assist Client in developing his/her personal Life Project byidentifying a clear, realistic, and measurable goal related to theLife Project. A goal should be:

•Realistic—can reasonably expect to be completed betweensessions

•Clear—Client understands exactly what steps must be takento complete this goal

•Not too easy and not too hard—goals should bechallenging, but not impossible or too global

•Have a clear end point—Client should know when a goalhas been completed


wrap-up 20 MINUTES

Fill out Goal Card, whichClient takes with him/her,and copy goal onto GoalRecording Sheet in ClientFile

Facilitator completesSession Notes in ClientFile. Complete QualityAssurance Check Sheet/Notes (page 8 of thissession).

For a more completedescription, please refer toReference Guide, pages9–11.

QQUUAALLIITTYY AASSSSUURRAANNCCEE CCHHEECCKK SSHHEEEETT / NNOOTTEESS


Client Facilitator

❏ Previewed content of Modules 1, 2, and 3

❏ Discussed and noted Client’s expectations for participation in the study

❏ Completed Life Context Form

❏ Discussed Concept of Life Project

❏ Began discussion of potential Life Project for Client

❏ Set goal related to Life Project; recorded it on Goal Card for Client, and on Goal RecordingSheet for Facilitator’s File

❏ Completed Session Notes for File

Notes (include observations of Client’s affect, engagement, and reaction to session elements)


Outcome: Client will identify personal stressors

Skill 1: Client will be able to discern changeable and unchangeable stressors

Skill 2: Client will identify how his/her thought processes affect moods and perceptions ofstressors



Module 1, Session 2 ............................90 minutes

•Check-In/Life Context .....................20 minutes•Review last week’s life events•Discuss progress of goal and Life Project•Preview Session 2 content•Discuss session content as it relates to the

Client’s life context

•Skills-Building..................................20 minutes•Enhance Client’s understanding of the

impact of stress on everyday life•Assist Client to develop Personal Stressors

List•Assist Client to narrow identified stressors

from global conditions to specificsituations, using Personal StressorsWorksheet

•Assist Client to classify identified stressorsas changeable or unchangeable (PersonalStressors Worksheet)

•Problem-Solving ...............................35 minutes•Assist Client to complete the "Reasons

Why" column of the Personal StressorsWorksheet

•Wrap-Up..............................................15 minutes•Assist Client in identifying how effectively

dealing with stress impacts other areas ofhis/her life

•Client sets goal related to personal specificstressors

•Review Client’s Life Project

•Client File•Personal Stressors List•Personal Stressors Worksheet•Goal Card•Goal Recording Sheet•Quality Assurance Check Sheet/Notes•Session Notes

•Pens, pencils


•Review significant events in Client’s life in past week,including Life Project

•Discuss goal set at last session including successes,accomplishments, and challenges

•Preview Session 2 content

•Discuss how stress impacts the Client’s life context. Suggestedtopic areas for discussion:

•Relationship(s)•Personal•Professional

•Quality of life•Optimism•Future goals•Physical health•Mental health


check-in/life context 20 MINUTES


•Enhance Client’s understanding of the impact of stress oneveryday life

•Symptoms •Effects of stress•Cost/benefit of stress•Management (not mastery) of stress

•Assist Client to develop Personal Stressors List (see page 12of this session)

•Assist Client to narrow one or two identified personal stressorsfrom global conditions to specific situations (see PersonalStressors Worksheet on page 13 of this session)

•Assist Client to classify the identified specific stressors aschangeable or unchangeable (refer back to Personal StressorsWorksheet)


20 MINUTESSkills-Building

Facilitator must assistClient to choose those"global" stressors that canbe broken down intospecific situations for thepurpose of this skills-building exercise. Issuessuch as "the government’slack of early response tothe epidemic" or "notenough drug treatmentfacilities in the city" may beappropriate if they can bebroken to direct personalimpact on the Client.Client should be workingon those areas of stresswhich are more personal innature and directly impactdaily functioning (thoseresulting in symptoms ofdepression and/oranxiety).

AACCTTIIVVIITTYY: “PPEERRSSOONNAALL SSTTRREESSSSOORRSS LLIISSTT”


AACCTTIIVVIITTYY: “PPEERRSSOONNAALL SSTTRREESSSSOORRSS WWOORRKKSSHHEEEETT”

HHEEAALLTTHHYY LLIIVVIINNGG PPRROOJJEECCTT MODULE 1, SESSION 2

13

STRESSOR CHANGEABLE UNCHANGEABLE REASONS WHY1. General

SpecificA. ❏ ❏

B. ❏ ❏

C. ❏ ❏

D. ❏ ❏

E. ❏ ❏

F. ❏ ❏

2. General

SpecificA. ❏ ❏

B. ❏ ❏

C. ❏ ❏

D. ❏ ❏

E. ❏ ❏

F. ❏ ❏


•Assist Client to complete the "Reasons Why" column of thePersonal Stressors Worksheet

•Choose as many specific stressors as time allows

•Explore the Client’s perception of what makes the stressorchangeable or unchangeable. Ask Client to describe howhis/her thoughts impact moods and perceptions of theidentified stressors.

•Assist Client to brainstorm ways to effective deal withidentified stressor. Steps include:

1. Identify the stressor2. Determine the goal3. Brainstorm alternative solutions4. Evaluate those solutions 5. Choose the most appropriate and best solution6. Develop an action plan7. Act

•Assist Client in identifying how effectively dealing with stressimpacts other areas of his/her life

•Assist Client in identifying a clear, realistic, and measurablegoal related to other stressor(s) identified on the PersonalStressor List. A goal should be:


problem-solving 35 MINUTES

If Client exhibits irrationaldecision-makingsurrounding changeable/unchangeable stressors, thefacilitator should take timeto explore his/herunderlying thoughtprocesses.



•Clear—Client understands exactly what steps must be takento complete the goal

•Not too easy and not too hard—goal should be challenging,but not impossible or too global


•Review Life Project, celebrating any progress


wrap-up 15 MINUTES

Fill out Goal Card, whichClient takes with him/her,and copy goal onto GoalRecording Sheet in ClientFile.



Client Facilitator

❏ Completed check-in with Client

❏ Discussed stress and impact of stress on Client’s life

❏ Completed Personal Stressors List

❏ Completed Personal Stressors Worksheet

❏ Identified changeable and unchangeable stressors from Personal Stressors List

❏ Completed "Reasons Why" column on Personal Stressors Worksheet

❏ Set goal related to stressor(s) identified on the Personal Stressors List; recorded it on GoalCard for Client and on Goal Recording Sheet for File

❏ Reviewed Life Project/progress

❏ Completed session notes for File




Outcome: Client will be able to appropriately apply emotion-focused and/or problem-focused copingstrategies to identified personal stressors

Skill 1: Client will apply an emotion-focused coping strategy to an unchangeable stressor

Skill 2: Client will apply a problem-focused coping strategy to a changeable stressor



Module 1, Session 3................................90 minutes

•Check-In/Life Context .........................20 minutes•Review last week’s life events•Discuss progress of goal and Life Project•Preview Session 3 content•Discuss session content as it relates to the


•Skills-Building......................................30 minutes•Review Client’s Personal Stressor Worksheet

from Session 2•Discuss Client’s current coping strategies for

handling stressors•List identified stressors and assist Client to

classify each as emotion-focused or problem-focused coping strategies (Stress and CopingWorksheet)

•Problem-Solving...................................25 minutes•Use emotion-focused strategies to problem-

solve one Client identified unchangeablestressor (Emotion-Focused Worksheet)

•Use problem-focused strategies to problem-solve one Client identified changeablestressor (Problem-Focused Worksheet)

•Wrap-Up .................................................15 minutes•Assist Client in practicing the identification

of alternative thoughts and behaviors relatedto other stressors in his or her life

•Client sets goal related to effective stressmanagement


•Client File•Personal Stressors Worksheet (from Session 2)•Stress and Coping Worksheet•Emotion-Focused Worksheet•Problem-Focused Worksheet•Goal Card•Goal Recording Sheet•Quality Assurance Check Sheet/Notes•Session Notes

•Pens, pencils


•Review significant events in Client’s life over the last week,including Life Project



•Identify how managing stress enhances the Client’s life context.Suggested topic areas for discussion:

•Relationship(s)•Personal•Professional

•Quality of life•Optimism•Future goals•Physical health•Mental health




•Review Client’s Personal Stressor Worksheet from Session 2

•Discuss Client’s current coping strategies for handlingstressors. Topics may include:

•Exercise•Relaxation techniques (meditation, deep breathing,

progressive muscle relaxation, visualization, etc.)•Substance use•Leaving situation•Social support •Others

•Discuss emotion-focused vs. problem-focused coping strategies

•Refer to strategies identified by Client to determine his/herprimary coping style

•Assist Client in identifying emotion-focused or problem-focused strategies that are likely to reduce stressors (see Stressand Coping Worksheet on page 20 of this session)



The purpose of thisdiscussion is to make theClient aware of anypotential imbalancebetween use of emotion-focused vs. problem-focused styles.

AACCTTIIVVIITTYY: “SSTTRREESSSS AANNDD CCOOPPIINNGG WWOORRKKSSHHEEEETT”


20

STRESSOR EMOTION-FOCUSED PROBLEM-FOCUSED REASONS WHY

1. ❏ ❏

1.

2. ❏ ❏

1.

3. ❏ ❏

1.

4. ❏ ❏

1.

6. ❏ ❏

1.


•Assist Client to problem-solve one identified unchangeablestressor utilizing emotion-focused strategies (see Emotion-Focused Worksheet on page 22 of this session). Steps shouldinclude:

1. Identify the stressor2. Determine the goal3. Brainstorm alternative solutions4. Evaluate those solutions5. Choose the most appropriate and best solution6. Develop an action plan7. Act

•Assist Client to problem-solve one identified changeablestressor utilizing problem-focused strategies (see Problem-Focused Worksheet on page 23 of this session). Steps shouldinclude:




AACCTTIIVVIITTYY: “EEMMOOTTIIOONN-FFOOCCUUSSEEDD WWOORRKKSSHHEEEETT”


22

STRESSOR STEPS

1. Identify the stressor


2. Determine the goal


3. Brainstorm alternative solutions


4. Evaluate those solutions



5. Choose the most appropriate

2. Determine and best solution

2. Determine and best solutions

6. Develop an action plan



AACCTTIIVVIITTYY: “PPRROOBBLLEEMM-FFOOCCUUSSEEDD WWOORRKKSSHHEEEETT”


23

STRESSOR STEPS










5. Choose the most appropriate

2. Determine and best solution

2. Determine and best solutions





•Assist Client in additional problem-solving for other lifestressors, utilizing emotion-focused or problem-focused copingstrategies

•Assist Client in identifying a clear, realistic, and measurablegoal related to the identified stressor. A goal should be:







wrap-up 15 MINUTES

Fill out Goal Card, whichClient takes with him/her,and copy goal onto GoalRecording Sheet in Clientfile.


QQUUAALLIITTYY AASSSSUURRAANNCCEE SSHHEEEETT / NNOOTTEESS

Client Facilitator


❏ Reviewed Personal Stressors Worksheet

❏ Discussed Client’s current stress coping strategies

❏ Discussed distinction between emotion-focused and problem-focused stressors

❏ Applied emotion-focused strategies to one identified unchangeable stressor

❏ Applied problem-focused strategies to one identified changeable stressor

❏ Client practiced identifying alternative thoughts and behaviors related to other identifiedpersonal life stressors

❏ Set goal related to effective stress management; recorded it on Goal Card for Client and onGoal Recording Sheet for File






Outcome: Client will increase positive supportive relationships

Skill 1: Client will identify three types of social support (emotional, informational, and tangible)

Skill 2: Client will identify positive sources of social support for each of the three categories



Module 1, Session 4 ............................90 minutes

•Check-In/Life Context .....................15 minutes•Review last week’s life events•Discuss progress of goal and Life Project•Preview Session 4 content•Discuss session content as it relates to the


•Skills-Building..................................30 minutes•Discuss the three types of social support•Discuss positive vs. negative social support•Assist Client to identify his/her personal

social support network(s)•Assist Client to identify members of

his/her personal support networkappropriate to each supportive category

•Problem-Solving ...............................25 minutes•Review Personal Stressor Worksheet (from

Session 2)•Assist Client to determine which

supportive category would be mostappropriate for each of the identifiedstressors

•Assist Client to identify who in their socialnetwork(s) would be most helpful inproviding support for each stressor

•Wrap-Up..............................................20 minutes•Facilitator assists Client to role-play social

support situations•Client sets goal related to increasing

positive social support•Review Client’s Life Project

•Client File•Personal Stressors Worksheet (from Session 2)•Social Support Worksheet•Goal Card•Goal Recording Sheet•Quality Assurance Check Sheet/Notes•Session Notes

•Pens, pencils


•Review significant events in Client’s life over the last, includingLife Project



•Identify how social support impacts the Client’s ability to copewith life stressors. Suggested topic areas for discussion:

•Significant other(s)•Family•Best friends•Close friends•Friends•Acquaintances



•Discuss the three types of social support1. Informational—information, advice, or suggestions2. Emotional—words and actions that make a person feel

cared about, understood, and affirmed. May includeempathy, caring, love, and trust

3. Tangible—money, labor, assistance, etc.

•Discuss positive vs. negative social support

•Explore the impact of Client’s mood (feeling down, joy,sadness, and anxiousness) on his or her ability to develop andmaintain positive social support

•Assist Client to identify his/her personal social supportnetwork(s) (refer to Social Support Worksheet on page 29 ofthis session)

•Assist Client to identify members of his/her personal supportnetwork appropriate to each support category (refer back toSocial Support Worksheet)



Be prepared to discussissues of abuse,abandonment, personalsafety, co-dependency, etc.

If Client is unable toidentify any socialsupport(s), facilitatorshould assist Client inbrainstorming how tobegin development of asupportive network

AACCTTIIVVIITTYY: “SSOOCCIIAALL SSUUPPPPOORRTT WWOORRKKSSHHEEEETT”

TANGIBLE SUPPORT

Social Support Network


©1997 Coping Effectiveness Training Workbook, Center for AIDS Prevention Studies, University of California—San Francisco

SERVICE PROVIDERS

ACQUAINTANCES

FRIENDS

BEST FRIENDS/FAMILY

TANGIBLE SUPPORT

EMOTIONALSUPPORT

INFORMATIONALSUPPORT


•Review Personal Stressor Worksheet from Session 2

•Assist Client in determining which support category (i.e.,informational, emotional, tangible), would be most appropriatefor each of the identified stressors. Problem-solving stepsshould include:


•Assist Client in determining who in their social network(s)would be most helpful in providing support for each stressor.Problem-solving steps should include:





•Assist Client in role-playing social support situations1. A social situation where Client may find positive social

support; or 2. A situation in which the Client decides to terminate an

established relationship which he/she believes to be anegative source of social support

•Assist Client in identifying a clear, realistic, and measurablegoal related to increasing positive social support. A goalshould be:







wrap-up 20 MINUTES




Client Facilitator


❏ Discussed three types of social support

❏ Discussed positive vs. negative social support

❏ Identified Client’s personal support network using Social Support Worksheet

❏ Discussed support categories (i.e., informational, emotional, tangible)

❏ Role-played social support situations

❏ Set goal related to increasing positive social support; recorded it on Goal Card for Client andon Goal Recording Sheet for File






Outcome: Client will develop a plan for decreasing stress by increasing adaptive coping strategies over thenext three months

Skill 1: Client will identify resources to assist in decreasing stress and increasing adaptive copingstrategies

Skill 2: Client will identify and problem solve challenges to decreasing stress and increasing adaptivecoping strategies



Module 1, Session 5....................................90 minutes

•Check-In/Life Context .............................15 minutes•Review last week’s life events•Discuss progress of goal and Life Project•Preview Session 5 content•Discuss session content as it relates to the


•Skills-Building..........................................20 minutes•Discuss Client’s successes in using adaptive

coping strategies•Discuss Client’s challenges to maintaining

adaptive coping strategies•Discuss Client’s successes in reducing

symptoms of stress•Discuss Client’s challenges in reducing

symptoms of stress

•Problem-Solving.......................................20 minutes•Assist Client in developing a plan to continue

to decrease stress over the next three months•Assist Client in developing a plan to continue

to increase adaptive coping strategies over thenext three months

•Wrap-Up .....................................................35 minutes•Assist Client in identifying resources and

skills that support his/her plan to decreasepersonal stress

•Assist Client in identifying resources andskills that support his/her plan to increasepersonal adaptive coping strategies

•Client sets goal related to reducing stressand increasing adaptive coping strategies


•Client File•Life Context Form (Session 1, pages 5–6)•Personal Stressors List (Session 2, page 12)•Personal Stressors Worksheet (Session 2, page 13)•Emotion-Focused Worksheet (Session 3, page 22)•Problem-Focused Worksheet (Session 3, page 23)•Social Support Worksheet (Session 4, page 29)•Goal Card•Goal Recording Sheet•Quality Assurance Sheet/Notes•Session Notes

•Pens, pencils


•Review significant events in Client’s life over the last week,including Life Project



•Identify how the skills developed over the last four sessionshave influenced his/her life context. Suggested topic areas fordiscussion:

•Personal Stressors List (Session 2, page 12)•Personal Stressors Worksheet (Session 2, page 13)•Emotion-Focused Worksheet (Session 3, page 22)•Problem-Focused Worksheet (Session 3, page 23)•Social Support Worksheet (Session 4, page 29)




•Discuss Client’s successes in reducing symptoms of stress

•Discuss Client’s challenges in reducing symptoms of stress

•Discuss Client’s successes in using adaptive coping strategies

•Discuss Client’s challenges to maintaining adaptive copingstrategies



Include in discussion areview of the worksheetsfrom previous foursessions:

•Personal StressorWorksheet

•Stress and CopingWorksheet

•Emotion-FocusedWorksheet

•Problem-FocusedWorksheet

•Social SupportWorksheet


•Assist Client to problem-solve a plan for decreasing stress overthe next three months. Problem-solving steps include:

1. Identify the stressor(s)2. Determine the goal.3. Brainstorm alternative solutions4. Evaluate those solutions5. Choose the most appropriate and best solution6. Develop an action plan7. Act

•Assist Client to problem-solve a plan for increasing adaptivecoping strategies over the next three months. Problem-solvingsteps include:

1. Identify the stressor(s)2. Determine the goal.3. Brainstorm alternative solutions4. Evaluate those solutions5. Choose the most appropriate and best solution6. Develop an action plan7. Act




•Assist Client in identifying resources and skills that supporthis/her plan to decrease personal stress

•Assist Client in identifying resources and skills that supporthis/her plan to increase personal adaptive coping strategies

•Review challenges encountered to goals set in previoussessions

•Assist Client in identifying a goal related to reducing stress andincreasing adaptive coping strategies over the next threemonths. A goal should be:





•Prepare the Client for the three month break and assessment



wrap-up 35 MINUTES




Client Facilitator


❏ Discussed Client’s successes and challenges regarding adaptive coping strategies

❏ Discussed Client’s successes and challenges regarding reducing symptoms of stress

❏ Developed a plan for Client to continue decreasing stress over next three months

❏ Developed a plan for Client to continue to increase adaptive coping strategies over the nextthree months

❏ Identified Client resources and skills to support plans regarding decreasing stress andincreasing adaptive coping strategies (above)

❏ Set a goal related to reducing stress and increasing adaptive coping strategies; recorded it onGoal Card for Client and on Goal Recording Sheet for File

❏ Discussed three-month break and assessment





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